Upton Arlo, Ellis-Pegler Rod B, Woodhouse Andrew
Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand.
N Z Med J. 2004 Aug 20;117(1200):U1020.
To review the Auckland Hospital Outpatient Parenteral Antimicrobial Therapy (OPAT) Service.
Patients (>15 years of age) were referred to the Service and assessed for suitability for outpatient therapy by an infectious diseases physician and a specialist nurse. Patient demographics, referring service, site of infection, and infecting organism, antimicrobial agent/s and outcomes of treatment including complications were recorded.
Over a 20-month period 100 patients were treated with 107 courses of outpatient parenteral antibiotic therapy. Bone and joint infections accounted for close to two thirds (60%) of the referrals; discitis/osteomyelitis (36%), septic arthritis (14%) and infected metalware/prosthetic joint infections (10%). Staphylococcus aureus was the most frequently isolated organism (42%), and in 21% of cases no organism was identified. In general, antibiotics prescribed were narrow spectrum and all but six patients self-administered up to four times daily. Eighty-eight percent of treatment courses resulted in a cure. Complications related to therapy occurred in 35% of patients.
We have found that parenteral antibiotic therapy can be administered safely and successfully in an outpatient setting despite relatively frequent dosing intervals. The majority of complications were minor, and 88% of patients were cured.
对奥克兰医院门诊胃肠外抗菌治疗（OPAT）服务进行评估。
将年龄大于15岁的患者转至该服务部门，由传染病科医生和专科护士评估其是否适合门诊治疗。记录患者的人口统计学信息、转诊科室、感染部位、感染病原体、抗菌药物及治疗结果（包括并发症）。
在20个月的时间里，100例患者接受了107个疗程的门诊胃肠外抗生素治疗。骨和关节感染占转诊病例的近三分之二（60%）；椎间盘炎/骨髓炎（36%）、化脓性关节炎（14%）以及感染的金属植入物/人工关节感染（10%）。金黄色葡萄球菌是最常分离出的病原体（42%），21%的病例未鉴定出病原体。一般来说，所开的抗生素为窄谱抗生素，除6例患者外，所有患者每天自行给药多达4次。88%的治疗疗程取得了治愈效果。35%的患者出现了与治疗相关的并发症。
我们发现，尽管给药间隔相对频繁，但胃肠外抗生素治疗在门诊环境中可以安全、成功地进行。大多数并发症较轻微，88%的患者得以治愈。
